The Oregon Clinic gastroenterologists are the first in the state of Oregon to offer an improved ability to manage bile duct pathology using a video technique called cholangioscopy during Endoscopic Retrograde Cholangiopancreatography (ERCP). Traditionally, ERCP relied on radiographic contrast images. At times, this limited its utility in evaluating bile duct lesions and managing large stones.
“The system used by The Oregon Clinic gastroenterologists consists of a single use cholangioscope that accommodates a small reusable optical fiber,” according to Dr. Lehel Somogyi, Gastroenterology, The Oregon Clinic. “The cholangioscope is advanced through the working channel of the duodenoscope into the bile duct while its handle attaches to the duodenoscope, allowing a single operator to manipulate both endoscopes.”
Cholangioscopy allows direct visualization of strictures and targeted biopsies, thus increasing the yield and efficacy. In addition, it allows treatments such as electrohydraulic lithotripsy of large stones within the duct under direct vision. Complementing this technology are other advanced techniques such as intraductal ultrasound examination of the bile duct, which uses a small ultrasound catheter passed through the duodenoscope into the biliary tree to gain additional information.
“These technologies are another step forward in the ability of The Oregon Clinic to provide the most comprehensive care for patients with biliary diseases,” noted Dr. Michael M. Owens, Gastroenterology, The Oregon Clinic.
Outcome studies show lower complication rate and higher procedural success rate for biliary procedures performed in high-volume centers. The Oregon Clinic Gastroenterologists perform more than 1,000 ERCPs annually, a volume comparable to some of the largest centers in the nation. The advancement of technologies and expertise are part of the comprehensive hepatic and pancreaticobiliary service offered by the physicians of The Oregon Clinic.